Purpose: Hansen{\textquoteright}s disease is endemic in over 140 countries worldwide and a potentially blinding condition. We describe a case of retinal vasculitis in a patient with Hansen{\textquoteright}s disease with concomitant positive antiphospholipid antibody serology, a potentially under-reported complication in this setting.
Methods: A 37-year-old Brazilian man systemically stable on triple therapy (clofazimine, rifampin, dapsone) for Hansen{\textquoteright}s disease presented for a comprehensive ophthalmic evaluation.
Results: Dilated exam revealed diffuse peripheral intraretinal hemorrhages in his right eye. Fluorescein angiography showed peripheral non-perfusion, abnormal shunt vessels and leakage from the retinal veins in the right eye and peripheral non-perfusion and vascular leakage in the fellow eye, consistent with vasculitis. Laboratory workup was notable for positive antiphospholipid antibodies (lupus anticoagulant, anticardiolipin IgM, anti-beta-2 glycoprotein 1 IgM) and normocytic anemia.
Conclusion: As antiphospholipid antibodies are present in a large proportion of patients with Hansen{\textquoteright}s disease, it is possible that retinal vasculitis may be more common than previously thought. The extent to which retinal vasculitis occurs in Hansen{\textquoteright}s disease remains uncertain and possibly underestimated due to the frequency of anterior segment scarring, which impedes retinal evaluation. Heightened surveillance for potential retinal vascular complications is warranted.
}, year = {2024}, journal = {Retinal cases \& brief reports}, month = {03/2024}, issn = {1937-1578}, doi = {10.1097/ICB.0000000000001560}, language = {eng}, }